Exam 2 TBI Dr. Shappy Flashcards Preview

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Flashcards in Exam 2 TBI Dr. Shappy Deck (90)
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1

TBI: Most common age group injured

young males

2

MOI for SCI

(three motions, four results)

 

some sort of method of acceleration/deceleration where the brain tissue smashes into the cranium

  1. Accerleration
  2. Deceleration
  3. Rotation

If any of these causes:

  1. Shearing,
  2. tearing,
  3. compression, or
  4. displacement of brain tissue

some method of trauma

Head doesn't actually have to hit something, but brain must slosh agains something

brain can rotate into scull

3

what is a focal injury?

 


–Area of impact
–Can result in bruising (hematoma), swelling (edema), Slicing/laceration/tearing of brain, coup-contra coup effect.
 

From Wikipedia:

Focal and diffuse brain injury are ways to classify brain injury: focal injury occurs in a specific location, while diffuse injury occurs over a more widespread area. It is common for both focal and diffuse damage to occur as the result of the same event; many traumatic brain injuries have aspects of both focal and diffuse injury.[1] Focal injuries are commonly associated with an injury in which the head strikes or is struck by an object; diffuse injuries are more often found in acceleration/deceleration injuries, in which the head does not necessarily contact anything, but brain tissue is damaged because tissue types with varying densities accelerate at different rates.[2]

http://en.wikipedia.org/wiki/Focal_and_diffuse_brain_injury

4

what are three ways to classify a brain injury?

 

  1. Focal Injjury
  2. Diffuse Axonal Injury (DAI)
  3. Hypoxic Ischemic Injury

5

what is DAI?

 

Diffuse Axonal Injury

6

Diffuse Axonal Injury

 


–Diffuse damage to neural tissue (axons)
 

From Wikipedia:

Focal and diffuse brain injury are ways to classify brain injury: focal injury occurs in a specific location, while diffuse injury occurs over a more widespread area. It is common for both focal and diffuse damage to occur as the result of the same event; many traumatic brain injuries have aspects of both focal and diffuse injury.[1] Focal injuries are commonly associated with an injury in which the head strikes or is struck by an object; diffuse injuries are more often found in acceleration/deceleration injuries, in which the head does not necessarily contact anything, but brain tissue is damaged because tissue types with varying densities accelerate at different rates.[2]

http://en.wikipedia.org/wiki/Focal_and_diffuse_brain_injury

7

what is a hypoxic ischemic injury

 


•Hypoxic Ischemic Injury

  • –Arachnoid damage
  • –Other stuff I didn’t get down

 

From International Brain Injury Association:

Hypoxic-ischemic brain injury is a diagnostic term that encompasses a complex constellation of pathophysiological and molecular injuries to the brain induced by hypoxia, ischemia, cytotoxicity, or combinations of these conditions (Busl and Greer 2010). The typical causes of hypoxic-ischemic brain injury – cardiac arrest, respiratory arrest, near-drowning, near-hanging, and other forms of incomplete suffocation, carbon monoxide and other poisonous gas exposures, and perinatal asphyxia – expose the entire brain to potentially injurious reductions of oxygen (i.e., hypoxia) and/or diminished blood supply (ischemia).

http://www.internationalbrain.org/articles/hypoxicischemic-brain-injury/

8

which types of TBI have bad outcomes?

 

DAI & Hypoxic injury = bad outcomes

9

what is a brain hematoma?

 

A bleed on the brain

10

what does Dura Mater man?

 

Dura Mater  = “tough mother”

11

What can brain hematomas cause?

 

 An increase in intracranial pressure

12

where are three common places that hematomas can happen in the brain?

 

  1. –Epidural
    • •above the dura
  2. –Subdural
    • •Below the dura
  3. –Intracerebral
    • •Between hemispheres
       

13

what does ICP stand for?

 

Intracrainial Pressure

14

what is considered normal ICP (for shappy)?

 


•Normal ICP 4 to 15 mmHg
 

15

what is the goal for Intracranial Pressur eto be able to do rehab?

 


•Below 20 mmHg- goal
 

16

The higher the ICP gets, the ______  the outcome

 

 

The higher the Intracranial pressure gets, the worse the outcome

 

17

The longer amount of time spend at higher ICP, the ______ the outcome

 

The longer amount of time spend at higher ICP, the worsethe outcome

18

What are three things that can be used to manage a high ICP?

  1. Intraventricular catheter
  2. Subural screw
  3. Epidural sensor

19

where are five places that a ICP cantheter can be placed? (picture it too)

  1. Epidulral
  2. Intraparencyhmal
  3. Subarachnoid
  4. Ventricular
  5. Subdural

20

List 7 tests that can be done to diagnose a TBI?

 

 

  1. •CT scan
  2. •MRI
  3. •PET scan
  4. •SPECT scan
  5. •FMRI
  6. •EEG
  7. •Neuropsychological testing
     

21

what happens to athletes twho get a concussion?

 

Concussion testing battery baseline

retest before they can return to play after concussion

Free of symptoms counts as day 1 (still might not be exactly where they were before)

22

why is exercise a risk after someone experiences a TBI?

Exercise increases BP that can increase intracranial pressure

23

What does PET stand for?

 

PET = Positron Emission Tomography

24

What does SPECT stand for?

 

SPECT  = Single Photon Emission Computerized Tomography

25

Does a mild concussion require imaging?

 

no

(but I think Dr. Shappy thinks it should)

26

What does FMRI stand for?

 

Functional Magnetic Resonance Imaging

(functional MRI)

clinician tells pt to do something and that area lights up on the MRI

see attached picture

27

what does DAI stand for?

 

Diffuse Axonal Injury

28

why is it good to look at any images we can get our hands on in the hospital?

 

The more we see these images along with symptoms, the more we understand them and we can develop expertise

29

what does Sequelae mean?

 

a condition that is the consequence of a previous disease or injury.

30

What are 11 Sequelae categories of TBI?

 

  1. •Neuromuscular Impairments
  2. •Cognitive
  3. •Orientation
  4. •Memory
  5. •Executive function
  6. •Behavioral
  7. •Communication
  8. •Visual-Perceptual
  9. •Dysphagia- swallowing
  10. •Dysarthria- speaking
  11. •Indirect impairments